The use of x-ray radiation for medical and non-medical applications is well known. In the medical arena, x-ray radiation therapy is a commonly used and accepted practice in the treatment of disease, including but not limited to, for example, tumors, certain skin diseases, and/or benign conditions. Historically, treatment first utilized external x-ray sources that supplied x-ray radiation to the target site. Where the target site was internal, such as a tumor, the applied x-ray radiation had to traverse the skin and other soft tissue and perhaps bone on its way to the target site, resulting in damage and burn to those tissues. Among other reasons, this disadvantage of x-ray therapy using external x-ray sources caused innovators to seek devices and methods to generate x-rays internally.
Generally speaking, there are two basic types of x-ray equipment in use today. One type relies upon heating an electron source to generate thermionically a beam of electrons that are then directed across a vacuum gap to a target material such as gold or tungsten or other high atomic number material. X-rays are generated upon the beam striking the target. In the second type, known as a field emission emitter, an electric field pulls electrons from a cathode across a vacuum gap toward an anode to strike a target material and generate the x-ray radiation. In both types, the generated electron beam is directed through a high vacuum to avoid electric breakdown and dissipation of the electron beam—and a subsequent reduction in the beam intensity—by atoms in the gap.
X-ray emitters for medical and non-medical applications take many forms. For example, one known type of emitter uses an x-ray source for intracavitary irradiation. The source comprises a housing, an elongated tubular probe, a target assembly, and an inflatable balloon. The housing encloses a thermionic electron gun and includes elements for directing the electron beam, generated in the housing, into the tubular probe. The tubular probe extends along a central axis from the housing about the beam path. The target assembly extends along the central axis and is coupled to the end of the probe distal from the housing. The target assembly includes a target element positioned in the beam path, and adapted to emit x-rays in response to the impinging electron beam. The balloon is affixed to the distal end of the probe and is inflatable so that when that probe end is inserted into a body cavity, the balloon may be inflated to stretch the cavity to a known shape.
The previously described apparatus has several drawbacks. First, the x-ray system has an inherent instability of its electron beam in the presence of a magnetic field. Because the thermionically generated electron beam must traverse the length of the probe between the electron gun and the target assembly, stray external magnetic fields can cause the beam to be deflected away from the target causing the generated x-ray flux to vary and complicating the calculation of the dose actually received by the patient. To address this drawback, the system requires an additional system for controlling the beam direction. Another drawback is that the apparatus includes an electron gun, which significantly adds both complexity and cost. Still another deficiency in this system is that the inflated balloon does not fix the position of the x-ray source relative to the patient's body and thus it requires an additional system for ensuring that the x-ray emitter is in the right position against the tissue to be irradiated.
Another x-ray device uses an X-ray needle for interstitial radiation treatment, This device includes an elongated X-ray tube coupled to an electron gun at one end of the tube, and a converter element converting the energy of electrons into the X-ray energy, disposed at the other end of the tube. The x-ray source comprises a solenoid coil wound around the tube for providing a magnetic field that confines the emitted electrons within a narrow beam. An elongated outer casing encloses the tube and coil. The x-ray source also includes a cooling system for removal of the heat generated by the converter and the magnetic coil. The drawbacks of the disclosed X-ray source are its relative complexity, large size and lack of adequate means for delivery of an optimal distribution of radiation dose across the predetermined volume of the target tissue.
Another known x-ray device utilizes a miniature X-ray tube with a direct current power supply and a field emission cathode. The tube has a needle cathode along its axis and an exit window at the end of the tube behind the cathode. The tube generates x-ray radiation along the axis of the device. It is not adapted for and cannot be used for treatment of tumors inside the body. Another drawback of the x-ray tube is an absence of the ability to control the operating current and voltage independently. This particular disadvantage inhibits manufacturing reproducibility.
In using x-rays for medical therapy it is important that the proper dose rate be applied. The dose depends upon the energy of the x-rays and the intensity of the x-ray beam. In field emission devices, increasing the voltage of the electric field increases the energy of the x-rays while increasing the current increases the intensity of the beam. Higher energy x-rays penetrate to greater depths in body tissue, so voltage control is important in controlling the energy to avoid damaging healthy tissue needlessly due to an undesired depth of penetration of the x-rays. The beam flux is also dependent upon the gap between the anode and the cathode. Increasing the gap decreases the beam flux and vice versa.
An undesirable feature of known field x-ray emitter devices is the inability to closely control the dose rate. One reason for this lack of control is that the generation of the electron beam from the cathode can be sporadic. That is, due to uncontrollable changes in the condition of the electron emitting surface of the cathode, field emitters are known for instability of their current, which can vary by a factor of 2. Because of the inconsistency in the current and thus the x-ray beam flux, the dose applied during any particular therapy session may not be well known, which leads to inconsistent treatment and results. The only sure way to know that a particular medical problem has been adequately addressed is to apply radiation at a presupposed rate that increases the likelihood of damage to healthy tissue.
There is a need for an apparatus and method that enables an operator of an x-ray apparatus to control the energy and intensity of an emitted x-ray beam by independently controlling the voltage and operating current, respectively. It would be desirable to have such an apparatus and method for use in standard operating rooms, which cannot currently be used where irradiation is supplied by widely used naturally occurring radioactive isotopes such as iridium 192 because of a lack of protection from the highly penetrating radiation produced by such sources. It would also be desirable to have an x-ray device that is not sensitive to the external magnetic field in the manner of x-ray sources using an electron gun. Additionally, it would be desirable for such an apparatus and method to provide a low cost source of ionizing radiation for radiation brachytherapy of brain, breast, prostate and other tumors or for radiation brachytherapy of non-tumor related medical problems such as macular degeneration in the eye.